Individual
DR. MARY LOU BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C., C.C.S.P.
Contact information
Practice address
409 E FRONT ST, BLOOMINGTON, IL 61701-5309
(309) 828-3415
(309) 828-2665
Mailing address
409 E FRONT ST, BLOOMINGTON, IL 61701-5309
(309) 828-3415
(309) 828-2665
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
038-005425
IL
Other
Enumeration date
09/28/2006
Last updated
09/28/2011
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